Idiopathic nephrotic syndrome (INS) is the most prevalent glomerular disease in children. The French High Council for Public Health (HSCP) recommends annual influenza vaccination in all children with INS. To this purpose, the Social Security automatically sends prescriptions to all patients followed for a chronic disease. The aim of this study was to evaluate the follow-up to these recommendations.

Material and methods:

We conducted a monocentric retrospective investigation of practices at Necker Children’s Hospital, Paris, France. We included all consecutive children with steroid-sensitive INS in remission who attended our pediatric nephrology clinics during the past 2 years (1st January 2015 to the 1st January 2017), resided in France and had a valid phone number. Data were collected from May 2017 to June 2017 by a phone interview of the patient’s parents/legal guardians

Results:

Among the 81 patients with steroid-sensitive INS, 77 met the inclusion criteria. Parents of 57 children could be reached by phone and agreed to participate to the survey, and 35/57 (61.4%) declared having received a prescription either from the French Social Security or from their pediatric nephrologist during the 2016-2017 campaign. Only 14 children (24.6%) were vaccinated against influenza during the campaign. Among the 43 unvaccinated patients, 17 (39.5%) had concerns about the safety of the vaccine, 16 (37.2%) parents were not aware of the recommendations, 5 (11.6%) were recommended by their physician not to be vaccinated, 3 (7%) forgot to get vaccinated and 2 (4.6%) had no reason for being non- vaccinated. Thirteen of the 43 (30%) presented a relapse during the flu season, two of which during an influenza-like illness, whereas two of the 14 (14%) immunized children presented a relapse during the six months of follow-up post-vaccination

Conclusions:

This survey shows that: less than two third of patients are properly prescribed the recommended yearly influenza vaccination at our center and only one fourth of the patients were vaccinated and most of their parents were misinformed. Pediatric Nephrologists and Pediatricians following INS patients must make every effort to better inform their patients of the risks of flu illness and the benefits and safety of the vaccination